What Is Heart Disease?
Heart disease is the leading cause of death in the United States. There are many different types of heart disease—some are congenital (people are born with them), while a majority of heart diseases develop over the course of time and affect people later in life.
Heart and blood vessel diseases are often referred to as silent killers because they usually develop over time and can go unnoticed. Many heart problems develop when the arteries, which supply the heart with blood, slowly clog with cells, fat, and cholesterol—a substance known as plaque. This build-up of plaque along the inner walls of the arteries can cause blood clots, or thrombi, to form, leading to further narrowing or blockage of the artery. This condition is known as ]]>atherosclerosis]]>, or hardening of the arteries. Lack of blood flow to the heart can cause a ]]>heart attack]]>, while lack of blood flow to the brain can result in a ]]>stroke]]>.
This article provides an overview of the following:
General Symptoms of Heart Disease
In people with heart disease, physical activity, emotional stress, and even eating can sometimes bring on symptoms. Blockages in the arteries of the heart often cause symptoms such as chest pressure, heaviness, tightness, or a squeezing sensation. Sometimes these sensations are mistaken for gas or indigestion. Symptoms of lack of oxygen to the heart are often experienced as pain in the neck, the back, the left arm, the throat, ears, jaws, or stomach. Some people experience symptoms in only one area, and not in the chest area at all.
Easy fatigue and breathlessness during activities may also be indicative of heart disease, as can difficulty breathing when lying flat, swelling of the ankles, and palpitations (strong and fast heart beats) accompanied by dizziness and other symptoms.
Common Types of Heart Diseases and Conditions
Coronary Artery Disease (CAD)
Blockage in the coronary arteries is called coronary artery disease—a condition in which the heart muscle doesn't get enough blood and oxygen to meet the demand.
Risk factors for coronary heart disease include:
- High blood cholesterol]]>
- ]]>High blood pressure (hypertension)]]>
- Physical inactivity
- Diabetes ( ]]>type 1]]> or ]]>type 2]]> )
- Family history of coronary artery disease
- Male gender
- Oral contraceptives (in women who smoke)
- Drugs such as cocaine
Forms of CAD
Coronary artery disease can take the following forms:
Silent ischemia is a form of CAD in which the blood flow to the heart muscle is reduced but produces very little pain or symptoms. Women, older adults, and people with diabetes may be more likely to have few or even no symptoms of heart disease.
Angina refers to pain or pressure in the chest, back, arm, or jaw—usually associated with exertion—which indicates that the heart muscle isn't receiving enough oxygen. Angina may be caused by a narrowing of the arteries or muscle spasms in the coronary arteries. Angina caused by spasms is called variant angina and it may be induced by cigarette smoke, cold temperatures, strong emotions, and other sources.
It is important to note that angina—which consists of brief symptoms that resolve in a few minutes—is not a heart attack. However, new angina or a worsening pattern of angina puts someone at increased risk of having a heart attack or ]]>cardiac arrest]]>. Unstable angina is chest pain that is not caused by exertion and does not go away with rest or medication. It is a sign that a heart attack will happen soon and is a medical emergency. The pain of angina can be relieved either by increasing the oxygen supply to the heart or by decreasing the heart's demand for oxygen. Thus, taking a rest from exertion or taking medication that dilates the arteries may relieve an episode of angina.
Heart Attack (Myocardial Infarction)
A heart attack occurs when blood flow to part of the heart is blocked and part of the heart muscle is damaged and dies as a result. There are now treatments that, if given in the first hours of a heart attack, can open up blocked arteries and limit the damage done to the heart muscle. In addition, during a heart attack, a person is at high risk of an ]]>arrhythmia]]> or sudden death. For these reasons, it is especially important for the heart attack victim to get medical help fast.
Some people may have few or no symptoms, but in general, the more warning signs and symptoms you have, the more likely it is that you are having a heart attack. Signs and symptoms include:
- Heavy feeling, pressure, or intense pain or squeezing in the chest that lasts for more than a few minutes
- Pain that radiates to the shoulders, neck, or arms
- Lightheadedness or fainting
- Shortness of breath
- Nausea or vomiting
Heart failure occurs when the heart isn't pumping as well as it should. As a result, the body doesn't get all the blood and oxygen it needs. Heart failure can be caused by coronary artery disease, heart attack, high blood pressure, diabetes, diseases of the heart valves, ]]>cardiomyopathies]]> (diseases that damage the heart muscles), ]]>alcohol abuse]]>, severe ]]>emphysema]]>, and other causes.
If you have the following symptoms of heart failure, see your doctor:
- Swelling in the feet, ankles, or legs, known as edema
- Shortness of breath on exertion, caused by fluid that builds up in the lungs, known as pulmonary congestion
Other symptoms of heart failure may include wheezing, shortness of breath when sleeping flat, cough, and fatigue.
Diagnosis of Heart Disease
The diagnosis of heart disease is often complicated. The following tests are often used to help make a diagnosis:
Treatment of Heart Disease
Treatment of heart disease depends on the type of disease as well as many additional factors. Coronary artery disease is treated with:
- Medications—These may include: aspirin]]>; beta-blockers; nitroglycerin tablets, spray, and patches; ACE inhibitors; angiotensin receptor blockers (ARBs) calcium channel blockers; and thrombolytic therapy
- Surgery—These may include: ]]>coronary angioplasty]]>, stents, and ]]>coronary bypass operation]]>
- Lifestyle Changes or Cardiac Rehabilitation—This usually consists of supervised exercise training, dietary counseling, weight management, smoking cessation and stress management.
Prevention of Heart Disease
Research has identified certain risk factors that make people more prone to heart disease. While some risk factors can't be controlled, such as being male or having a family history of heart disease, those related to lifestyle can be controlled and may provide significant long-term benefits. Further, risk factors often overlap. By making changes in one area of your life, such as becoming more physically active, you may decrease your cholesterol levels and blood pressure.
The following steps can help reduce the risk of certain heart diseases:
- Lowering the cholesterol level in your blood through dietary changes]]> and medication
- ]]>Engaging in regular physical activity]]> (preferably aerobic activity, a minimum of 30 minutes of moderate exercise per session, at least five times per week)
- ]]>Keeping weight or body fat in a healthy range]]>
- ]]>Not smoking]]>
- Keeping blood pressure in a healthy range
American Heart Association
National Heart, Lung, and Blood Institute
Physical Activity for Everyone (CDC)
Heart and Stroke Foundation of Canada
Balady GJ, Williams MA, Ades PA, Bittner V, Cosmoss P, Foody JM, et al. Core Components of Cardiac Rehabilitation/Secondary Prevention Programs: 2007 Update: A Scientific Statement From the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology,, and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary. Circulation.2007;115:2675-2682.
Blumenthal JA. Depression and coronary heart disease: Association and implications for treatment. Cleve Clin J Med. 2008;75(Suppl. 2):S48-S53.
Smith SC, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, et al. AHA/ACC Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update. Circulation. 2006;113:2363-2372.
Last reviewed January 2009 by ]]>Janet H. Greenhut, MD, MPH]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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